Living with A-fib: Tips and outlook

Atrial fibrillation, commonly known as A-fib, is an irregular heartbeat. It can lead to the heart not pumping enough oxygen-rich blood to the rest of the body.

With proper medical treatment, people with A-fib can lead a full, healthy life. There are also several changes that people can make to improve their quality of life and help reduce the severity of symptoms.

Lifestyle changes

Though living with A-fib can be challenging, there are several steps a person can take to deal with the condition besides receiving regular medical care. These include:

Beginning or increasing an exercise routine is a recommended lifestyle change for people with A-fib.

Quitting smoking can improve living with A-fib and reduce further heart and lung risks.

Increasing and continuing exercise is important for people with A-fib. As with any exercise routine, a person should consult their doctor to ensure it is safe for them.

Eating a heart-healthy diet can impact on overall health and fitness and people with A-fib should eat less trans fat and sugar, while increasing their green leafy vegetables, lean proteins, and fiber intake.

Maintaining a healthy weight, through both diet and exercise, can help.

Reducing alcohol consumption as alcohol intake can have a negative impact on the heart. Some people with A-fib need to avoid alcohol altogether, so everyone with the condition should consult their doctor before drinking.

Managing stress as this can complicate A-fib. People with A-fib can take steps to reduce their stress levels through exercise, meditation, or other methods.

People with A-fib should also maintain follow-up care with their doctor to ensure proper treatment is continued.

What does A-fib do to the body

A-fib can have a number of potential impacts on the body ranging from mild to severe. Some of these include:

Blood clots: When the heart is not pumping hard enough, blood can pool and form a clot within it. If a clot escapes it can cause issues elsewhere in the body.

Heart problems: Over time, the irregular beating can cause the heart to weaken.

Shortness of breath: Irregular pumping of the blood to the lungs can result in fluid building up, which can then lead to shortness of breath and fatigue.

A-fib may also lead to a buildup of fluid in the legs, ankles, and feet. Other problems can include weight gain, light-headedness, and a general sense of being unwell. Additionally, people may experience irritability and tiredness during previously routine activities.

A-fib itself is generally not life-threatening but the condition can lead to severe complications, which include stroke and heart failure.

A stroke may occur after a blood clot has formed in the heart and moved towards the brain, blocking an artery. A doctor will often be most concerned about a person's risk of a stroke when they are diagnosed with A-fib. Symptoms of stroke should not be ignored, including headache and slurred speech.

Heart failure can be a long-term effect of unmanaged A-fib. The condition weakens the heart over time, making a person more likely to suffer from new or worsening heart failure. The threat of heart failure can be reduced greatly by medical supervision of A-fib.

Treatment

Electrical cardioversion may be used to treat A-fib by shocking the heart to stop it so that it may restart with a regular beat.

Doctors treating A-fib typically look at treatments to reset the rhythm of the heart, control the rate it is beating, and reduce the risks of blood clots.

The way a doctor treats A-fib depends on a number of factors, including whether the person has other heart problems, other medications they are taking, their response to previous treatments, and the severity of their A-fib.

Cardioversion

Cardioversion is used to reset the heart rhythm. It can be electrical or carried out with drugs.

Electrical cardioversion involves shocking the heart to temporarily stop it with the aim that when restarted, it will resume with regular beats. Typically, this procedure is done under sedation.

Cardioversion can also be delivered through medication, called anti-arrhythmics, which are delivered into the vein, or by mouth. Very often, the initial treatment is conducted in a hospital. However, a doctor may prescribe similar medications to be taken regularly to prevent further episodes.

A doctor will likely prescribe blood thinners to be taken for several weeks to prevent clots before cardioversion treatment. A test for blood clots may also be done before cardioversion.

Preventive medication

Several types of medication can control heart rhythm and heart rate.

After a cardioversion, a doctor may prescribe anti-arrhythmic medications to prevent further problems with heart rhythm including dofetilide, flecainide, propafenone, amiodarone, and sotalol.

To control heart rate, a doctor may prescribe medications that include digoxin, calcium channel blockers, and beta-blockers.

Catheter and surgical procedures

In cases where medication is not effective, additional procedures should be taken. These include:

Catheter ablation: Long, thin tubes are inserted into the groin and guided through blood vessels to the heart. Electrodes at the tips can destroy the areas causing A-fib, scarring the tissue so that the erratic electrical signals return to normal.

Surgical maze procedure: Using a scalpel, a doctor creates a pattern of scar tissue in the upper chambers of the heart. The scar tissue can't carry electricity, so the scars interfere with stray electrical impulses that cause A-fib. The procedure involves open heart surgery.

Atrioventricular (AV) node ablation: The tissue pathway connecting the upper chambers and lower chambers of the heart (AV node) is destroyed with a catheter. In this procedure, a pacemaker is then implanted to control the responsibilities of the AV node. People who have this procedure may still need to take blood-thinning medications to prevent clots from forming.

Preventing blood clots

Warfarin may be prescribed to help prevent blood clots.

As blood clots are a major concern for people with A-fib, a doctor is likely to prescribe medication that helps prevent these. This is particularly true if a person has issues with heart disease.

The two types of medication typically prescribed are warfarin and newer anticoagulants. Warfarin medications need to be used with care under direct supervision of a doctor, as they can cause dangerous bleeding.

Newer anticoagulants do not require such frequent monitoring as warfarin.

Coping and outlook

A-fib is a commonly diagnosed condition. As a result, there are many treatment options and therapies that can greatly reduce the symptoms or correct A-fib.

Treating A-fib can allow a person to live a normal life. Left untreated, a person could experience further complications such as stroke or worsening heart disease.

Recognizing the signs, being proactive in making lifestyle changes, and treating A-fib are the best ways to help prevent complications.

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